医生的看法,准备报告以及与受损和无能同事相关的经验
Catherine M DesRoches1, Sowmya R Rao, John A Fromson
1Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St, Ste 900, Boston, MA 02114, USA. cdesroches@partners.org
JAMA
|July 15, 2010
概括
医生同意报告受损或无能的同事,但往往不采取行动. 障碍包括相信其他人会报告或害怕报复,影响患者安全.
科学领域:
- 医学专业主义 医学专业主义
- 医生的表现 医生的表现
- 医疗保健质量保证 医疗保健质量保证
背景情况:
- 同行监测对于识别医生损伤和无能至关重要.
- 现有的数据表明,这些问题报告不足.
- 医生自我调节是医疗实践的基石.
研究的目的:
- 调查医生对受损或无能同事的态度,准备和经验.
- 确定影响医疗实践问题的报告因素.
- 了解专业承诺与实际报告行为之间的差距.
主要方法:
- 一项针对美国各个专业的2938名医生进行的全国代表性调查.
- 收集关于信念,准备和与受损/无能同事的经验的数据.
- 报告率的分析和不报告的原因.
主要成果:
- 64%的医生支持报告受损/无能同事的承诺.
- 只有69%的人认为他们准备好处理有障碍的同事,而64%的人认为他们准备好处理无能的同事.
- 17%的人知道一位无能同事;67%的人报告了他们,代表性不足的少数群体不太可能报告.
结论:
- 医生承认报告的职业义务,但报告率低于最佳水平.
- 相信别人会采取行动或害怕报复是不采取行动的关键原因.
- 解决这些障碍对于改善患者安全和医疗保健质量至关重要.
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